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Anxiety - Behavioral & Cognitive Strategies for Treating Anxiety
On the last track we discussed detecting and exposing anxiety. We discussed three techniques you can use to help your client detect and expose anxiety. The three techniques were analyzing and attacking anxiety by discussing the costs of anxiety, cognitive therapy, and clearing roadblocks to change.
On this track we will discuss treating phobic conditions. As you know, attempts to treat phobic conditions tend to reflect established methodologies of various health care specialties more than they have addressed the complexity of phobias. I find that the basis for treating phobic conditions in a therapeutic setting often involves providing clients with tools which they can use in everyday life to cope with phobias.
First, let’s discuss Claire Weekes’s Self-Care Approach. For more than 30 years, physician Claire Weekes has pioneered the idea of giving self-care tools to those who suffer from agoraphobia. Her books, which show great understanding and empathy for those suffering from agoraphobia, have brought hope and help to hundreds of thousands of readers in Great Britain, Australia, and the United States. Weekes’s self-care approach is applicable to most phobias. She describes her treatment in the following way:
"My treatment is based first on adequate explanation to the patient of sensitization and nervous symptoms, secondly on teaching the importance of the four concepts—facing, accepting, floating, letting time pass—and finally, on the full explanation of the obstacles met during all stages of recovery and warning of the probable occurrence of setbacks and their treatment. Working this way, many patients need little or no drug therapy. Recovery lies not in the abolition of nervous sensations and feelings (as so many patients believe), but in their reduction to normal intensity.
Do you agree with Weekes’s position on nervous sensations and feelings and with the importance she places on keeping her clients fully informed about the obstacles and setbacks that are part of the recovery process? Behaviorally, the four CBT concepts constitute a useful self-care technique for coping with the experience of panic and anxiety. Facing, accepting, floating, and letting time pass are steps which can establish conditions in which desensitization can occur.
The first concept outlined by Weekes, facing, is a skill that may take some time to acquire. Of course, as Weekes makes clear, what clients learn to face are arising thoughts and feelings, not locations or situations. Should a client like Greg retreat from a feared situation instead of facing it, it can benefit him to see his behavior in terms of learning a new skill, not in terms of a life-and-death struggle.
Would you agree that full and complete recovery from a phobic condition can best be ensured by fitting together a self-directed treatment program that is both systematic and comprehensive? What are some differences between your approach and Weekes’s? Do you emphasize the importance of understanding the philosophy of helplessness and how it arises in the first place?
On this track we have discussed treating phobic conditions. Our discussion was based on Claire Weekes’s Self-Care Approach. Weekes’s Self-Care Approach is comprised of four concepts for coping with phobic conditions. Weekes’s four concepts are face, accept, float, and let time pass. For more information on Weekes’s approach, consult the Bibliography which accompanies this course.
On the next track we will discuss successive approximations. Successive approximations consist of setting subgoals, identifying triggers, and implementing the technique through behavior.
Peer-Reviewed Journal Article References:
Bowler, J. O., Mackintosh, B., Dunn, B. D., Mathews, A., Dalgleish, T., & Hoppitt, L. (2012). A comparison of cognitive bias modification for interpretation and computerized cognitive behavior therapy: Effects on anxiety, depression, attentional control, and interpretive bias. Journal of Consulting and Clinical Psychology, 80(6), 1021–1033.
Craske, M. G., Niles, A. N., Burklund, L. J., Wolitzky-Taylor, K. B., Vilardaga, J. C. P., Arch, J. J., Saxbe, D. E., & Lieberman, M. D. (2014). Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: Outcomes and moderators.Journal of Consulting and Clinical Psychology, 82(6), 1034–1048.
Goldin, P. R., Ziv, M., Jazaieri, H., Werner, K., Kraemer, H., Heimberg, R. G., & Gross, J. J. (2012). Cognitive reappraisal self-efficacy mediates the effects of individual cognitive-behavioral therapy for social anxiety disorder. Journal of Consulting and Clinical Psychology, 80(6), 1034–1040.
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